Kahrau S, Foitzik T, Klinnert J, Buhr H J
Abteilung für Allgemein-, Gefäss- und Thoraxchirurgie, Universitätsklinikum Benjamin Franklin, Berlin.
Zentralbl Chir. 1998;123 Suppl 4:17-8.
We analyzed 276 patients operated on for acute appendicitis between January 1995 and June 1997. In 26 patients intraoperative assessment revealed a pathological finding other than appendicitis. Fifty-nine patients (24%) had a perforated appendix, 116 acute appendicitis verified by histological examination, 75 (30%) chronic fibroplastic appendicitis or no signs of appendicitis. Patients with histologically acute inflammation fulfilled more clinical criteria of appendicitis than those without (5.1 vs. 3.7). Negative histological findings were most common in younger females admitted on Mondays and Tuesdays. Clinical observation rather than immediate operation and laparoscopy rather than laparotomy appear appropriate for the latter group and may lower the rate of negative appendectomy.
我们分析了1995年1月至1997年6月期间因急性阑尾炎接受手术的276例患者。26例患者术中评估发现除阑尾炎外的病理结果。59例患者(24%)阑尾穿孔,116例经组织学检查证实为急性阑尾炎,75例(30%)为慢性纤维增生性阑尾炎或无阑尾炎体征。组织学上有急性炎症的患者比没有急性炎症的患者符合更多阑尾炎的临床标准(5.1比3.7)。组织学检查结果为阴性在周一和周二入院的年轻女性中最为常见。对于后一组患者,临床观察而非立即手术,腹腔镜检查而非剖腹手术似乎更为合适,并且可能降低阴性阑尾切除术的发生率。